Patient portals: Pitfalls, promises, and potential
Most healthcare organizations have implemented some form of a patient portal to meet meaningful use requirements mandated by the federal government. Providers hope that their EHR patient portal will help improve communication with patients, enabling them to intervene before a small medical problem turns into a hospital re-admission, and help them boost patient satisfaction scores.
That sounds wonderful, but here is the problem with most portals today: Patients have little interest in using them because they don’t offer enough value.
Patients don’t care about meaningful use and the fact that their provider will lose money if they don’t create an account and actually use the portal. Patient portals are notoriously obsolete and difficult to navigate, and patients often struggle to interpret medical information, such as test results.
Do portals improve outcomes?
An extensive body of research exists related to patient portal usability and satisfaction among users. Until now, few studies have looked at the impact of portals on hospital outcomes. A new study out of the Mayo Clinic Hospital in Jacksonville, Florida, and published in the Journal of the American Medical Informatics Association in December last year found that 30-day readmissions, inpatient mortality, and 30-day mortality were virtually the same when comparing hospitalized patients who used portals with those who did not. The researchers concluded that patient portals might not ultimately improve hospital outcomes.
Researchers also discovered that of the 44 percent of patients who registered for a portal account, just 20.8 percent accessed it while they were hospitalized – that’s merely 9 percent of patients. Researchers noted that higher adoption rates could have a bigger impact on outcomes and added that future efforts should focus on patient experience and engagement.
A focus on the patient
I couldn’t agree more with the need to focus on the patient. Technology alone doesn’t impact outcomes. Providers must take a more holistic approach and integrate technology into care management process and structure if they hope to increase portal use. Those who continue to focus on the patient portal as a technology solution rather than a valuable tool for patients risk irrelevance.
Consider the downfall of the once ubiquitous driving directions tool MapQuest as an example. Years ago, MapQuest was one of the best options for getting driving directions before you set off on your road trip. While it still exists — it was the No. 2 mapping service in the U.S. as of 2015 — it’s been largely outmoded by Google Maps, Apple Maps, and other smartphone-based GPS services that have rendered pre-printed driving directions obsolete.
MapQuest certainly helped pave the way for today’s GPS mapping services. However, it failed to evolve as smartphone use accelerated, driving consumers to adopt navigation tools that were more useful and convenient.
The challenge in improving patient portal usability is that many organizations still do not fully see patients as consumers, perhaps because the odds are relatively low that they’ll take their business elsewhere. However, with the increased availability of online information about healthcare providers, including quality ratings and patient comments, this is changing quickly.
There is no arguing that EHRs are necessary for documenting care episodes. Giving patients and providers a quick look at health status, health history, test results, and medication lists is a nice start. But it’s only a window into what has already happened.
True engagement is much more than a series of snapshots of past care episodes. In order to impact outcomes, physicians need to know what is happening with patients right now to determine what is likely to happen next.